Provider Demographics
NPI:1841280542
Name:SPAHR, JEFFREY LEE (OD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LEE
Last Name:SPAHR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8098 CLEAR WATER DR
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-3073
Mailing Address - Country:US
Mailing Address - Phone:303-781-5152
Mailing Address - Fax:
Practice Address - Street 1:3350 S BROADWAY
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2428
Practice Address - Country:US
Practice Address - Phone:303-781-5152
Practice Address - Fax:303-781-7441
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT 1538152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4467973OtherAETNA PPO/POS
COCO1538OtherEYEMED
CO29513OtherEYE CARE NETWORK
CO920350OtherBLOCK VISION INC.
CO2233944OtherAETNA HMO
CO08915381Medicaid
CO132051OtherCOLE MANAGED VISION
CO43503OtherBLUE CROSS BLUE SHIELD
CO2233944OtherAETNA HMO
COF4113Medicare ID - Type Unspecified